To approve as a correct record the minutes of the Health and Wellbeing Board meeting held on Insert dateInsert year.

Welcome and Introductions

Members were invited to introduce themselves and explain their role.

Cllr Little formally thanked Cllr Halden for the work he had done on driving forward the work of the Health and Wellbeing Board and Health and Wellbeing Strategy as the previous Chair of the Board.

Members were advised that there would be a short break during the meeting for refreshments and indeed for future meetings.

Senior officers who no were no longer members of the Health and Wellbeing Board were formally thanked for the contributions they had made: these were Steve Cox, Corporate Director for Place (Thurrock Council), Rory Patterson (Corporate Director for Children’s Services (Thurrock Council), Jeanette Hucey Director of Transformation (Thurrock Clinical Commissioning Group) and Malcolm McCann (Executive Director of Community Services and Partnerships (Essex Partnership University NHS Foundation Trust).  It was noted that this would be Malcolm McCann’s last meeting and that EPUT would be represented in future by Nigel Leonard.

Apologies were noted.

Minutes

The minutes of the Health and Wellbeing Board meeting held on 15 February 2019 were approved as a correct record.  

To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972.

There were no urgent items raised in advance of the meeting. 

There were no declarations of interest.

This item will be presented by Jo Cripps, Programme Director (Interim)

Mid & South Essex Sustainability and Transformation Partnership

This item was presented by Jo Cripps, Programme Director (Interim), Mid & South Essex Sustainability and Transformation Partnership.  Key points included:

·         The Mid and South Essex Sustainability and Transformation Partnership is a partnership of key organisations and groups within the mid and south Essex footprint, including:

o   Five Clinical Commissioning Groups (Thurrock, Basildon & Brentwood, Mid-Essex, Southend and Castle Point and Rochford)

o   Three Local Authorities (Thurrock Council, Southend-on-Sea Borough Council and Essex County Council)

o   Three acute hospitals (Basildon & Thurrock, Southend and Broomfield)

o   Three community and mental health providers (North East London Foundation Trust, Provide and Essex Partnership University NHS Foundation Trust)

o   Three Healthwatch organisations (Thurrock, Essex and Southend)

o   Chairs of the Sustainability and Transformation Partnership Service User Advisory Group and Clinical Cabinet.

·         As part of considering the reconfiguration of Acute Care a Decision Making Business Case was considered and approved by a Clinical Commissioning Group Joint Committee, which included proposals to close Orsett Hospital. 

·         Both Thurrock Council and Southend Health Overview and Scrutiny Committees referred the decisions of the Clinical Commissioning Group Joint Committee to the Secretary of State of Health and Social Care for independent review.   Thurrock Council’s concerns related specifically to the closure of Orsett Hospital and the quality of the consultation that had been undertaken to inform proposals made in the Decision Making Business Case.     

·         The Sustainability and Transformation Partnership are required by NHS England to develop a 5 year strategy, working with colleagues within the Partnership to recognise place based plans which will be reflected in the final strategy. 

·         The draft strategy is to be developed over summer and members were reassured that an update would be provided at the Health and Wellbeing Board in September.

Action STP Team

·         Healthwatch Thurrock are leading and coordinating engagement on the NHS Long Term Plan, which will ensure that action taken is informed by the residents of Thurrock.

·         It was highlighted that the independent Chair of the Sustainability and Transformation Partnership, Dr Anita Donley OBE, had announced her intention to stand down from the role.  Interviews are being scheduled for 22 July.

During discussions the following points were made:

·         Members noted the lack of clarity being provided on the definition of Integrated Care Systems and that the Mid and South Essex does not correspond with any other geographical boundaries other than that of the acute hospitals.

·         Members were advised that the Health Overview and Scrutiny Committee referral was submitted in January 2019 regarding the closure of Orsett hospital.  The referral was being considered by an Independent Reconfiguration Panel and a report is expected to be provided to the Secretary of State by 9 July 2019. 

·         Members were also updated that the Mid and South Essex Sustainability and Transformation Partnership had been asked to financially contribute to Cambridgeshire and Peterborough Sustainability and Transformation Partnership due to their negative financial position.  This had been discussed at the Health and Wellbeing Overview and Scrutiny on 13 June 2019.  Members were concerned about how the reduction to Thurrock  ...  view the full minutes text for item 4.

This item will be presented by Ian Wake, Director of Public Health

This item was presented by Ian Wake, Director of Public Health.

Key points included:

·         The paper recognises the various Governance Structures with the Sustainability and Transformation Partnership footprint and the need to ensure that the appropriate focus is provided to planning and commissioning of service at the STP, Place and locality geographical levels.

·         The Kings Fund report, ‘A year of integrated care systems’ undertook a qualitative evaluation of ‘vanguard’ Integrated Care Systems sites in England.  The purpose of their study was to understand how the early adopter Integrated Care Systems are being developed and identify lessons learned.  The Kings Fund reported there is no ‘blueprint’ for developing an Integrated Care Systems. Although, the best governance arrangements related to a focus on the place level (Thurrock) as most integration was not carried out at the Sustainability and Transformation Partnership level.

·         The paper provides a proposed revised governance structure which brings together the Thurrock Integrated Care Alliance, the Integrated Commissioning Executive under single one partnership board and with Integrated Medical Centre Programme Board and Mental Health Transformation Board reporting into it.  The Better Care Together groups have been merged into one board in order to build on the locality workings and 4 new locality model delivery groups have also been proposed.

During discussions the following points were made:

·         Members welcomed a Memorandum of Understanding regarding governance, and the commitment provided by the Sustainability and Transformation Partnership of avoiding duplication. 

·         It was noted this paper related to emerging thinking within Thurrock.  Members learned about the previous reservations regarding the growing centralisation and decision making remit of the Sustainability and Transformation Partnership.  However, it was recognised that Thurrock is part of a wider system and it is important to ensure that all partners have a commitment to working together to ensure the planning and commissioning of services is managed effectively. 

·         Members welcomed the inclusion of children’s services being considered as part of the report.

RESOLVED: Health and Wellbeing Board members supported the recommendations made within the paper.

This item will be presented by Roger Harris / Christopher Smith

This item was jointly presented by Roger Harris, Corporate Director for Adults, Housing & Health and Interim Director for Children’s Services, and Christopher Smith, Programme Manager for Health and Social Care Transformation.  Key points included:

·         The council entered into a Memorandum of Understanding (May 2017) with Basildon and Thurrock Hospitals NHS Foundation Trust, Essex Partnership University NHS Foundation Trust, North East London NHS Foundation Trust, and Thurrock Clinical Commissioning Group. A dedicated programme management resource, reporting to an alliance of the council and health partners, has recently been commissioned to oversee delivery of the Integrated Medical Centres.

·         The Integrated Medical Centres will serve local populations and will be situated in the following locations:

o   Grays - Thurrock Community Hospital has been designated as the location for the new Integrated Medical Centre for Grays, and is the only site which will be predominantly a refurbishment of an existing healthcare facility rather than an entirely new-build development. 

o   Tilbury/Chadwell - The council, Thurrock Clinical Commissioning Group and health service providers have worked collaboratively to develop a schedule of accommodation that can be provided at Tilbury and Chadwell Integrated Medical Centre. This accommodation includes provision for:

§  Multi-functional consultation and examination rooms;

§  Therapy rooms;

§  Treatment rooms;

§  Interview rooms;

§  Group rooms;

§  Phlebotomy bay;

§  Mobile imaging docking bay;

§  Shared workspace;

§  Library;

§  Community hub; and

§  Public access meeting rooms.

o   Purfleet – this Integrated Medical Centre is at an earlier stage as it is part of the wider Phase 1 development proposal submitted by Purfleet Centre Regeneration Ltd.  The schedule of accommodation is being finalised with partners and detailed design work will then commence. The funding strategy is still to be finalised and delivery is anticipated to be by 2022.

o   Stanford and Corringham - The delivery of the Stanford and Corringham Integrated Medical Centre is being led and funded by North East London NHS Foundation Trust.  Planning consent was secured in 2016 and amended in 2018 to extend the proposed opening hours.   A decision on the Business Case for the development is expected to be taken by the North East London NHS Foundation Trust Board imminently.  The site has consented development plans, therefore there is a lesser dependency on the outcome of the referral of the decision to close Orsett Hospital.  However, there had been a delay in securing primary care input, however this is now progressing.  It is anticipated that this Integrated Medical Centre could be operational from late 2021.

During discussions the following points were made:

·         The Secretary of State referral regarding the closure of Orsett hospital would need to be resolved/clarified before Integrated Medical Centres business cases can be approved.

·         Members queried if there was an alternative plan if the Orsett hospital closure did not go ahead or was delayed.  Members learned that the Stanford and Corringham site was less dependent on the Orsett hospital closure as the footprint was fixed due to planning permissions already granted although there would be an element  ...  view the full minutes text for item 6.

This item will be presented by Maria Payne, Strategic Lead – Public Mental Health & Adult Mental Health Systems Transformation

Maria Payne, Strategic Lead – Public Mental Health & Adult Mental Health Systems Transformation presented this item.  Key points included:

·         The Prevention Concordat for Better Mental Health was launched in 2018, and is underpinned by an understanding that taking a prevention-focused approach to improving the public’s mental health is shown to make a valuable contribution to achieving a fairer and more equitable society.

·         The concordat promotes evidence-based planning and commissioning to increase the impact on reducing health inequalities, and encourages actions that impact on the wider determinants of mental health and wellbeing.

·         The concordat is intended to provide a focus for cross-sector action to deliver a tangible increase in the adoption of public mental health approaches across:

o   Local authorities

o   NHS

o   Public, private and third sector organisations

o   Educational settings

o   Employers

·         It represents a public mental health informed approach to prevention, as outlined in the NHS Five Year Forward View, and promotes relevant NICE guidance and existing evidence-based interventions and delivery approaches, such as ‘making every contact count’.

·         Any partnership, organisation, community or alliance who has a commitment to prevention of mental health problems and promoting good mental health can become a signatory.

·         The rationale for Thurrock to sign the Concordat is that the council are already working collaboratively in a manner which the Concordat endorses and there is evidence of partnership working.

During discussions the following points were made:

·         Members endorsed and welcomed the signing of the Concordat, commenting that it was a positive and would need to be embedded in the wider council policy and practice.

·         Additional evidence was provided, particularly in terms of looked after children whereby they are given a passport which contains relevant numbers and support. 

·         Positive examples were also provided regarding the mental health services in Grays, specifically MIND and Inclusion which work in partnership with each other.   

RESOLVED:  The Health and Wellbeing Board agreed the following:

·         To endorse the activity outlined in the Prevention Concordat submission

·         To sign the Prevention Concordat for 2019/20

·         To be the named lead signatory.

·         Members discussed the work programme for the next meeting in September.

·         The Chair requested for those individuals who do not regularly attend to be contacted; this would be taken forward by Darren Kristiansen.

Action Darren Kristiansen

·         Apologies were received in advance of the September meeting for Mandy Ansell & Ian Wake. 

The meeting finished at 12.55 hours. 

CHAIR………………………………..

DATE…………………………………